This form is for Canadian students only. International students should visit the Financial Questions for International Students page for more information about the health plan.
This form must be submitted before 20 September 2019.
Insurance will be valid from 1 September 2019 to 31 August 2020.
Please provide the following information for your existing health insurance plan:
Please provide the following information for your existing dental insurance plan:
I have neither health nor dental insurance, so I must pay $590.40 for the two plans.
No payment is required when submitting this form. The cost of the insurance plan will be added to your bill from the Finance Department.
Because I already have health insurance, I must pay $265.68 for the dental insurance plan.
Because I already have dental insurance, I must pay $336.72 for the health insurance plan.
I have neither a family health insurance plan, nor a family dental insurance plan, so I must pay $1262.16 for both plans.
Because I only have a family health insurance plan, I must pay $520.56 for the family dental insurance plan.
Because I only have a family dental insurance plan, I must pay $753.60 for the family health insurance plan.